What is arterial hypertension? This is a disease characterized by blood pressure readings above 140 mm Hg. Art. in this case, the patient is visited by headaches, dizziness and a feeling of nausea. Eliminate all the symptoms that have arisen can only be specially selected therapy.
Arterial hypertension can be an independent disease or accompanies various pathologies, being their symptom. Hypertension is one of the causes of coronary heart disease and severe kidney damage.
In hypertensive patients, the indicators often return to normal only after taking special drugs, and pressure surges can be observed regularly and for no apparent reason. It is completely impossible to cure the disease, but preventing serious consequences and learning to control your pressure is a feasible task.
Do not self-medicate. At the first sign of illness, consult a doctor.
Causes
Until today, the exact reasons for which essential arterial hypertension could occur is unknown. There are the following risk factors:
- heredity;
- malnutrition;
- bad habits;
- violation of fat metabolism;
- kidney disease;
- diabetes;
- stress;
- inactive lifestyle.
Disease classification
During a diagnostic examination, it is very difficult to determine the location of the concentration of pathological factors that cause an increase in pressure. Pathogenesis also has differences taking into account the varieties of the disease. There is the following classification of arterial hypertension:
- Pulmonary essential arterial hypertension - is considered one of the varieties of arterial hypertension, rare, but representing a great danger to human life. It is very difficult to determine this ailment by symptoms, and even more difficult to treat. Pulmonary arterial hypertension is formed due to an increase in pulmonary vascular resistance and, as a result, insufficient blood flow.
- Malignant. Symptoms of such arterial hypertension are presented in the form of increased blood pressure up to 220/130. there is a radical change in the fundus and swelling of the disc of the optic nerve. If the diagnosis was made on time, then it is possible to cure this type of arterial hypertension.
- Renovascular arterial hypertension. The reasons for the formation of this type of disease are the presence of such pathologies as vasculitis, vascular atherosclerosis, and malignant formations in the kidneys. The pathogenesis of the disease is reduced to the formation of characteristic pressure, which can be represented in normal systolic and elevated diastolic blood pressure.
- Labile arterial hypertension. For this type of disease, periodic normalization of pressure is characteristic. Patients suffering from this form of arterial hypertension are not called patients, since this condition is not a pathology. In some cases, over a period of time, blood pressure returns to normal.
Symptomatic arterial hypertension and its types
Secondary arterial hypertension is a pathological process that is associated with diseases of the organs involved in the normalization of blood pressure. It has the following classification:
- Hemodynamic - associated with violations of hemodynamic conditions due to organic pathology of large vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the walls of the aortic chamber, coarctation of the aorta, aortic valve insufficiency.
- Neurogenic. This type of symptomatic arterial hypertension occurs due to diseases of the peripheral nervous system, brain injuries, atherosclerosis.
- Endocrinopathy. This form of symptomatic arterial hypertension is observed in hormonally active tumors of the adrenal glands, pituitary gland, diffuse toxic goiter.
- Nephrogenic arterial hypertension. This type of symptomatic arterial hypertension occurs for the following reasons: inflammation of the kidneys, their compression, nephrolithiasis. Nephrogenic arterial hypertension is accompanied by a sudden onset, rapid and often malignant course. Nephrogenic arterial hypertension is divided into two types: renovascular and parenchymal.
- Medicinal. This form of symptomatic arterial hypertension is associated with the use of drugs that increase blood pressure.
Symptoms
Before there are complications of arterial hypertension, it proceeds without certain manifestations. The only symptom of this disease is high blood pressure. The pathogenesis of hypertension is reduced to the formation of headaches in the back of the head and forehead, dizziness and uncharacteristic sound in the ears.
Target organ damage
This kind of symptoms of arterial hypertension occur very first due to the increased sensitivity of these organs to increased pressure. The first stage of circulatory disorders is characterized by the formation of headaches and dizziness. Subsequently, the patient has weakness, flashing of black dots before his eyes, difficulty in speaking. Such symptoms disturb a person at a late stage of the disease. In addition, complications such as cerebral infarction and hemorrhage may occur.
Heart failure
In this case, the pathogenesis of the disease is reduced to an increase in the left ventricle due to a compensatory reaction aimed at normalizing wall tension. As a result, increased afterload, heart failure. When the heart is damaged, there are not the most favorable forecasts, because such changes in its work are the causes of heart failure, sudden death and the development of ventricular rhythm disorders. The characteristic symptoms are:
- pulmonary edema;
- difficulty breathing at the time of physical activity;
- cardiac asthma.
In some cases, arterial hypertension in children and adults causes pain in the region of the heart of a certain nature. They can visit a person in a state of rest or emotional overstrain without performing physical activity. The main manifestation of the presented chest pains is the impossibility of their elimination with the help of nitroglycerin.
The pathogenesis of this pathological process in some patients is reduced to the formation of shortness of breath at an early stage of the disease after the implementation of small loads or at rest. All this indicates characteristic changes in the heart muscle and the formation of heart failure. With such a disease, people have swelling of the lower extremities, the cause of which is the retention of sodium and water ions in the body.
If the lesion has affected the kidneys, then when passing a urine test, a protein is found in it, and microhematuria and cylindruria are also observed. Very rarely, the pathogenesis of the disease involves the occurrence of renal failure.
Eye damage
Not so often, this arterial hypertension in children and adults affects the eyesight, resulting in a decrease in light sensitivity and blindness. If there is visual impairment against the background of high blood pressure, then patients have black dots before the eyes, fog or veil. The reasons for such changes are the violation of blood circulation in the retina. Complications can manifest as diplopia, visual impairment or complete loss of vision.
Headache
This symptom is considered the most common in arterial hypertension. She worries the patient at any time of the day or night. It can be bursting in nature and focus in the back of the head, and then spread throughout the entire head area. Increased headaches in arterial hypertension occurs when coughing, tilting the head. This may be accompanied by swelling of the eyelids and face. When performing massage in this case, in patients suffering from arterial hypertension, there is an improvement in the outflow of blood in the veins, and this leads to a decrease in pain until its complete disappearance.
There are cases when headaches against the background of the presented disease are the result of tense soft muscles of the head itself or tendons. The formation of such a pain syndrome occurs after a psycho-emotional or physical overstrain. As a rule, such pain is squeezing or tightening in nature. A patient suffering from arterial hypertension has a feeling of nausea, dizziness. In the presence of prolonged pain, incessant pain is characteristic, irritability occurs in patients, sensitivity to sharp sounds increases, they become quick-tempered.
Stages of the disease
For the correct setting of the stage of this pathological process, it is necessary to use the classification. It depends on the target organ damage. There are three stages of the disease.
Easy
This stage is characterized by a slight increase in blood pressure of 180/100 mm Hg. Art. pressure level is unstable. During rest in a patient suffering from arterial hypertension, blood pressure indicators return to normal. Due to the fixation of the disease, the pressure inevitably rises. Very often, people do not complain about the formation of any disorders regarding their health. But for an easy stage, its own symptoms are characteristic:
- headaches;
- noise in ears;
- bad sleep;
- mental decline;
- dizziness;
- nosebleed.
As a rule, there are no manifestations of left ventricular hypertrophy, ECG has no abnormalities, kidney function without pathological changes, the fundus is not changed.
Medium
This stage is characterized by the presence of a higher and more stable level of blood pressure. It can reach 180–105 mm Hg. Art. patients often experience headaches, dizziness, pain in the region of the heart, which have angina pectoris.
This stage is characterized by typical hypertensive crises. The pathogenesis of the disease involves the following signs of damage to target organs:
- hypertrophy of the left;
- weakening of the I tone at the apex of the heart;
- accent II tone on the aorta;
- in some patients, ECG symptoms of subendocardial ischemia.
Regarding the central nervous system, there are various manifestations of vascular insufficiency, cerebral strokes, transient cerebral ischemia. For the fundus, in addition to reducing arterioles, there is compression of the veins, their increase, hemorrhages, exudates occur. The blood flow in the kidneys and the glomerular filtration rate for this stage are reduced. But it is impossible to detect these manifestations in the analysis of urine.
heavy
This stage of the disease is characterized by frequent vascular accidents. They arise due to a significant and stable rise in blood pressure, as well as the progression of arteriosclerosis and atherosclerosis of larger vessels. At this stage, blood pressure reaches 230–120 mm Hg. Art. there is no spontaneous normalization of blood pressure. In a severe stage, the disease affects the following organs:
- heart - angina pectoris, circulatory failure, myocardial infarction, arrhythmias are formed;
- brain - ischemic and hemorrhagic infarcts, encephalopathy are formed;
- ocular fundus;
- kidneys - low blood flow and glomerular filtration.
Risk factors
At present, the severity of the described disease directly depends on the risk facts. The risk lies in the formation of cardiovascular complications against the background of high blood pressure. Taking into account the presented complications, the prognosis of the consequences of arterial hypertension is diagnosed. There are the following risk factors that worsen the course of the disease and its prognosis:
- age - in men after 50 years, in women after 60 years;
- smoking;
- high cholesterol;
- hereditary factor;
- obesity;
- hypodynamia;
- diabetes.
The presented risk factors can be eliminated (correctable) and may not be correctable. The first type of risk factors is characterized by the presence of diabetes mellitus, high cholesterol, smoking, physical inactivity. Uncorrected risk factors include race, family history, and age.
Taking into account the degree of arterial hypertension and the contributing factors of the disease, a forecast is observed with the formation of such complications as a heart attack or stroke for the next 10 years.
With a mild degree of arterial hypertension and the absence of risk factors, the formation of complications of the cardiovascular system is minimized for the next 10 years. With non-drug therapy for one year and a revision of your lifestyle, it is possible to eliminate this degree of the pathological process. If the pressure readings are greater than 140/90 mm Hg. Art. , then drug treatment is prescribed.
The average degree of risk is accompanied by the formation of complications against the background of arterial hypertension for 10 years in a ratio of 20%. Arterial hypertension of the 2nd degree is treated in the same way as the 1st degree, but here the control of the dynamics is also adjusted for six months. If there are poor results of blood pressure and its stable maintenance, then drug treatment is carried out.
Risk factors of a high degree are accompanied by the formation of complications within 30%. In this situation, a patient suffering from arterial hypertension is prescribed a complete diagnosis in combination with non-drug treatment.
At a very high risk, the patient is prescribed an urgent differential diagnosis of arterial hypertension and taking medications.
Diagnostic methods
Only after a thorough study can you prescribe effective therapy and eliminate all manifestations of this disease. Diagnosis of arterial hypertension is based on the following types of examination:
- ECG, glucose analysis and complete blood count;
- Ultrasound of the kidneys, determination of the level of urea, creatinine in the blood, general urinalysis - are carried out in order to exclude the renal nature of the formation of the disease;
- Ultrasound of the adrenal glands is advisable to carry out if pheochromocytoma is suspected;
- analysis for hormones, ultrasound of the thyroid gland;
- MRI of the brain;
- Consultation with a neurologist and an ophthalmologist.
Effective Therapy
Treatment of arterial hypertension should be carried out under the constant supervision of a physician. It is he who is obliged to make an accurate diagnosis, to perform additional diagnostics, which includes checking:
- fundus;
- kidney function;
- the work of the heart.
After that, the specialist can prescribe antihypertensive treatment, determine various complications. As a rule, patients in whom the syndrome of arterial hypertension was detected for the first time are hospitalized in order to carry out all the necessary studies and choose a treatment.
Non-drug treatment
Such therapy is recommended for all patients, regardless of the degree of disease of the use of medications. Such treatment for hypertension includes:
- To give up smoking. It is very important to change your lifestyle, such changes serve as an excellent prevention of diseases of the cardiovascular system.
- Elimination of extra pounds. A common cause of high blood pressure is excess weight, so diet plays an important role in this matter. In addition, a balanced and proper diet has a beneficial effect on risk factors such as diabetes mellitus, myocardial hypertrophy.
- Reduced amount of salt intake. According to ongoing studies, a reduced amount of salt consumed to 4. 5 g / day helps to reduce systolic blood pressure by 4-6 mm Hg. Art.
- Insignificant consumption of strong drinks.
- Specially designed diet. Your diet should include vegetables, fruits, foods high in magnesium, potassium, potassium, fish, seafood. In addition, the diet involves a limited intake of animal fats.
- Active lifestyle. Here, brisk walking for 30 minutes 3-4 times a week is very useful. When performing isometric loads, you can provoke a rise in blood pressure.
Medical treatment
Therapy with drugs should be prescribed taking into account the following recommendations:
- Treatment begins with small doses of drugs.
- In the absence of a therapeutic effect, it is necessary to replace the use of one drug with another. The interval between degrees should be less than 4 weeks, provided that a rapid decrease in blood pressure is not required.
- The use of long-acting drugs to obtain a 24-hour effect with a single dose.
- Application of the optimal combination of devices.
- Therapy should be permanent. It is not allowed to use the drug in courses.
- Effective control of blood pressure throughout the year contributes to a gradual reduction in the dose and amount of medication.
Preventive actions
Prevention of arterial hypertension includes the following recommendations:
- If family members have this disease and you are over 30 years old, then you need to regularly measure your pressure.
- Give up smoking and alcohol.
- A low-fat and low-salt diet should be followed.
- Exercise outdoors.
- Avoid various stressful situations.
- Maintain normal body weight.
With arterial hypertension, a person may well live a normal full life, but subject to all the recommendations described. The control of blood pressure in this case is one of the main components of the successful treatment of the disease. Therefore, try not to start the disease and visit a doctor in a timely manner in order to avoid various serious complications.